Bilateral maxillary augmentation using CAD/CAM manufactured allogenic bone blocks for restoration of congenitally missing teeth: A case report

Abstract

Objective Various biomaterials have been successfully applied in alveolar bone regeneration, however, the reconstruction of extensive osseous defects remains challenging and is often unfeasible with granular grafting materials. Several studies have outlined allogenic bone blocks as valid alternative to autologous block grafting. Clinical Considerations In this report, we demonstrate the regeneration of two large osseous defects in the maxilla with allogenic bone blocks made from human donor bone. The bone blocks were customized using the CAD/CAM technology in order to enable the insertion of four dental implants. Conclusions Both blocks perfectly matched the defect geometry, showed limited resorption, led to the formation of sufficient amounts of mineralized bone in both horizontal and vertical dimensions and enabled the installation of implants according to the treatment plan. The implementation of innovative technologies for individualization of allogenic bone blocks simplifies the restoration of complex and extensive osseous defects and poses great benefits for both practitioners and patients. Clinical Significance The here presented procedure demonstrates the successful regeneration of two extensive osseous defects in a patient suffering from hypodontia using two CAD/CAM manufactured allogenic bone blocks, rendering the procedure far less invasive as compared to guided bone regeneration carried out with autologous transplants. Furthermore, to the best of our knowledge, this is the first case report that radiographically demonstrates the new formation of a cortical bone layer following block grafting with solely cancellous bone blocks.

Alveolar ridge augmentation using the shell technique with allogeneic and autogenous bone plates in a split‐mouth design—A retrospective case report from five patients

“…Positive experiences with allogeneic bone blocks are indicated for a wide range of bony defects including horizontal and vertical alveolar ridge augmentations, 41‐43 post‐traumatic reconstruction, 44,45 and sinus lift with reduced residual bone height 46,47 . Even cleft lip and palate have been successfully treated with allogeneic blocks 38,48 . The most common complications associated with allogenic bone blocks were membrane exposure and loosening of the osteosynthesis screws 49 …”

Customized allogeneic bone grafts for maxillary horizontal augmentation: A 5‐year follow‐up radiographic and histologic evaluation

“…This case report showed the complete remodeling of the customized allogeneic block with the formation of new vital bone, which was indistinguishable from healthy native bone tissue. Therefore, our study together with results published by others emphasizes customized allogeneic bone blocks to demonstrate a successful and lasting treatment concept for augmentation of complex defects of the alveolar ridge 4,32,33 …”

“…Customized allogeneic bone grafts have been demonstrated to function as an ideal scaffold for the augmentation of alveolar ridge defects with high success rates and great predictability 1‐5 . Compared to other biomaterials, allografts provide favorable characteristics in terms of graft and particle size as well as a favorable inter‐ and intraparticulate porous geometry to supply osteoconductive effects and to maintain the graft volume 6 .…”

“…Nowadays, computer‐aided design/computer‐aided manufacturing (CAD/CAM) technology enables the individualized manufacturing of allogeneic bone blocks for complex alveolar ridge augmentation procedures. Several case reports already demonstrated the high precision fit and the successful application of customized allograft blocks 2‐5 . However, so far there are limited reports about the long‐term fate of the implanted bone allografts 8‐10 .…”

A novel digital and visualized guided bone regeneration procedure and digital precise bone augmentation: A case series

“…Blume et al 39 used CAD/CAM technology to process the living donors' bone blocks and also achieved satisfactory results. In addition, De Stavola et al proposed computer‐guided osteotomy to improve the efficiency and safety of the surgery 40‐45 …”